Incidental thyroid carcinoma: analysis of 578 thyroglossal duct remnants

Thyroid carcinoma presenting within thyroglossal duct remnants is rarely reported. No definite agreement exists regarding the therapeutical management after excision of the cyst. Especially necessity of total thyroidectomy is discussed controversial. A series of five cases is presented and relevant literature is reviewed.

A retrospective review of all patients with thyroglossal duct cyst carcinoma treated between 2002 und 2017 was performed.

Out of 578 patients with a thyroglossal duct cyst in five (3 women and 2 men) in the age of 16 – 73 years (mean: 51, median: 56 years) a thyroid carcinoma could be identified. All of them presented with a painless hyoidal swelling. Diagnosis was made in all cases after surgery, but in one case, malignancy was presumed in the preoperative MRI. Papillary thyroid carcinoma was found in all samples. Four of the patients underwent total thyroidectomy and radioiodine therapy, in two of them a neck dissection of medial and lateral compartement was performed. The last patient withdrew from further diagnostics and therapy. In all four samples, no carcinoma of the thyroid gland or nodal metastasis was found.

Due to the rare occurence of thyroid carcinoma in thyroglossal duct cysts, therapeutical management is controversial. Sistrunk procedure seems to be sufficient in many cases. To identify patients, who would benefit from additional thyroidectomy, risk stratification should be used. Prognosis is excellent.

Publication History

Publication Date:
23 April 2019 (online)